Thursday, December 18, 2014

Premenstrual Syndrome (PMS)

Definition

Premenstrual syndrome (PMS) is the term used to describe a group of physical or behavioral changes that some women go through before their menstrual periods begin every month. PMS can produce discomfort in different parts of the body and cause unpleasant emotional feelings.

Description

For reasons that remain unclear, these physical discomforts or mood changes begin at various times near the end of the menstrual cycle and usually disappear after a woman has begun her menstrual period. They reappear at about the same time each month.

The degree of discomfort from PMS varies with each individual. Most women with PMS have symptoms that cause a mild or moderate degree of distress. In about 10 percent of all women with PMS, symptoms may be severe.

PMS can have a major impact on a woman's life. On the job or at home, a woman may not be able to function as well when symptoms occur. Problems caused by PMS may trigger marital and family conflicts. A woman may become less outgoing socially and avoid friends when symptoms occur.

Women who have PMS can be helped. Education is the most important step in understanding this condition. Certain treatments can be useful in some women. A number of changes that cause various degrees of discomfort have been found in women with PMS:

Physical Changes - bloating, weight gain, breast soreness, abdominal swelling, headache, clumsiness, constipation, swollen hands and feet, and fatigue.

Behavioral Changes - depression, irritability, anxiety, tension, mood swings, inability to concentrate, and a change in sex drive.

One does not need all of these problems to have PMS. Most women with PMS have only certain ones. Some women have more difficulty with changes that affect their bodies; others have more problems with emotional changes. The severity of discomfort felt also varies from woman to woman. Some months may be more stressful than others. Occasionally, PMS disappears temporarily for no reason.

Causes

No one knows for certain what causes PMS. It is probably related to the change in hormone levels that occur in a woman's body before menstruation. While hormone levels appear to be normal in women with PMS, researchers are now studying the possibility that estrogen and progesterone may act in combination with chemicals made in the brain to cause some of the symptoms of PMS. The most important aspect of PMS is that it follows a pattern. Changes always occur during the second half of the menstrual cycle and are repeated each month. To be called PMS, symptoms must follow a certain pattern:

Women with PMS may have discomfort during the last three to 14 days before their menstrual periods. They usually gain rapid relief of their symptoms once their menstrual periods begin. This pattern must be repeated for at least two cycles before PMS is considered a possible reason for the symptoms.

If the problem is PMS, a woman should also be free of typical discomfort for at least two weeks a month. Any problem that lasts longer than two weeks is probably not PMS.

Treatment

There are no known universally effective ways to relieve PMS symptoms. Strictly limiting salt intake may help to reduce the fluid retention and bloating that can occur in the premenstrual period.

Regular exercise improves blood circulation, reduces swelling and eliminates fluids and salts through sweating. If these methods prove ineffectual, some doctors may prescribe diuretics, which help to flush the body of excess fluid.

Limiting or eliminating caffeine intake may decrease the amount of nervous tension that accompanies PMS. Some women find relief from PMS symptoms by taking extra doses of vitamin B6 during the premenstrual period. However, a woman should never take more than 300 milligrams of this vitamin per day, because excessive doses of vitamin B6, taken over a long period of time, can cause neurological problems.

Psychotherapy or support groups may help a woman deal with some of the ways PMS affects her life. It may also help her to deal with the underlying issues that may be exacerbated by the stress of coping with PMS.

Mefenanic acid (a pain-relieving, anti-inflammatory drug) has been successfully used to decrease the severity of PMS symptoms in many women.

Progesterone has also been found by some physicians to relieve some of the symptoms of PMS. While its efficacy is difficult to establish in clinical trials, numerous testimonials from women who have used progesterone therapy suggest that it can relieve severe physical symptoms, such as migraine headaches.

Questions

Do the signs and symptoms establish a diagnosis of premenstrual syndrome?

What are the probable causes?

Are normal hormone levels indicated?

What choice of treatment is there?

Would progesterone help?

How do women cope with this condition day in and day out?

Is psychotherapy indicated?